Surgery for Crohn's disease is associated with a high recurrence rate and quality of life in these patients is controversial.
Dr Wexner and colleagues from Florida assessed the quality of life in patients after laparoscopic and open surgery for Crohn's disease.
The investigative team used 2 different validated instruments, a generic nonspecific score and a specific gastrointestinal quality of life index.
Quality of life scores were 103 for the Gastrointestinal Quality of Life Index|
The team included patients with Crohn's disease who underwent elective laparoscopic or open ileocaecal resection with primary anastomosis.
The investigators followed up patients who underwent resection between 1992 and 2000 for recurrence and surgery-related complications.
The team measured quality of life by the SF-36 Health Survey containing a mental and a physical component summary score and by the Gastrointestinal Quality of Life Index developed by Eypasch.
The team evaluated 37 patients with a mean age of 49 years, including 23 females and 14 males at a mean follow-up of 43 months.
The investigators reported that 21 patients underwent laparoscopic resection and 16 open surgery.
Both groups were well matched for age, gender, and body mass index.
The investigative team noted that 14 patients developed recurrent disease and 3 had postoperative incisional hernias.
Overall, quality of life scores were 103 for the Gastrointestinal Quality of Life Index, 47 for the physical component summary, and 49 for the mental component summary.
The investigators found that the Gastrointestinal Quality of Life Index correlated well with the SF-36 Health Survery and the physical component summary.
The team also found a strong correlation between Gastrointestinal Quality of Life Index and the mental component summary of the SF-36 Health Survey.
The investigators reported that, compared to the general US population, the mean Gastrointestinal Quality of Life Index scores and mean physical component summary scores were significantly lower in these patients than in healthy individuals.
In a multivariate analysis of impact factors on quality of life, the team observed recurrence to be the single determinant reducing the physical component summary.
The team added that recurrence was also the only determinant to reduce the Gastrointestinal Quality of Life Index.
Dr Wexner's team concludes, “Quality of life is significantly reduced in patients with Crohn's disease at long-term follow-up after both laparoscopic and open surgery.”
“Recurrence is the only factor adversely affecting quality of life of Crohn's disease patients in remission irrespective of the operative technique applied.”